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Introduction: Previous research has indicated that community‐based mental health services in Iran are restricted, leading to overcrowding in psychiatric wards. This overcrowding has been linked to a range of problems, such as violence, suicide and medical errors. Despite the abundance of research on patient safety, there is still a lack of understanding regarding how mental health nurses (MHNs) create a secure environment within these wards. Aim: This study focused on exploring a safe environment provided by MHNs in inpatient psychiatric wards at Farshchian (Sina) Hospital, Hamadan, Iran. Method: An explanatory mixed‐methods study was conducted. Initially, the Safe Environment Scale was distributed to all MHNs (n = 48) working in three wards at Farshchian (Sina) Hospital to evaluate the current status. The scale measured two dimensions, and descriptive statistics were used to analyse the collected data. Subsequently, 20 MHNs were selected for semi‐structured interviews using purposeful sampling at the same hospital to interpret and fill gaps in the quantitative findings. The data collected from the interviews were analysed using conventional content analysis. Results: The perception and engagement of MHNs in creating a safe environment in the inpatient psychiatric wards were found to be at a medium level, according to the Safe Environment Scale (mean ± SD, 14.67 ± 4.18 and 85.27 ± 17.57, respectively). The qualitative study identified several categories in the results, including 'Hyper‐vigilance to safety and security environment', 'Therapeutic communication gap', 'Nurse burnout', 'Staff safety and security need' and 'Environmental safety hazards'. Discussion: MHNs employ a hyper‐vigilant strategy to guarantee a secure atmosphere within psychiatric wards. However, this approach may inadvertently impede the establishment of a safe environment and even diminish MHNs' perception and involvement in its maintenance. Implications for mental health nursing: According to our research, it appears that MHNs need to improve their education and training in order to successfully implement the vigilance strategy for establishing a secure environment. Additionally, it is essential for them to prioritize therapeutic communication with patients, as this plays a vital role in promoting a safe environment within inpatient psychiatric wards. [ABSTRACT FROM AUTHOR]

Background. Domestic violence comes in various forms, such as psychological, verbal, sexual, etc., and during pregnancy it has many complications, including maternal and foetal. Objectives. This study aimed to investigate a variety of interventions performed concerning domestic violence and its dimensions in pregnant women in a systematic review. Material and methods. The databases of Scopus, PubMed, SID and Web of Science were searched for the observational and interventional studies published in Persian and English examining interventions in domestic violence cases in pregnant women. The used keywords were “Domestic violence, Intervention, Pregnancy and other areas of violence”. Unrelated and common cases were eliminated from 6,056 retrieved studies, and finally, the remaining articles consisted of 1, 6 and 11 articles concerning emotional, psychological and social interventions, respectively, along with 7 review articles. Results. Studies have shown that most interventions are related to the emotional, psychological and social domains. The principles of interpersonal psychotherapy and rehabilitation counselling were emphasised in the psychological domain. In the social domain, most of the reviewed interventions indicated that researchers’ efforts and the type of interventions were mostly based on social support, which is based on the structure and framework ranging from one’s family level to society. Social applications of increasing women’s health and safety were introduced through increasing effective interaction with healthcare providers, increasing the adoption of safety behaviours and improving providers’ ability to detect domestic violence. Conclusions. According to the reviewed studies, an integrated care system should be used that can encompass all effective factors in preventive interventions and continuous and effective care. [ABSTRACT FROM AUTHOR]

Introduction: Maintaining patient dignity in a caregiving environment is one of the most important moral responsibilities for caregivers. Nonetheless, there are vulnerable groups, specifically teenagers, who in their final stages of life are prone to their dignity being threatened. Moreover, dignity is an abstract concept and there is no studies done on teenagers' dignity in the final stages of life available in Iran. Purpose : The purpose of this study is to describe the caregivers' experiences regarding teenagers' dignity in the final stages of life. Research design : This study is a descriptive phenomenological qualitative research project. The data was collected using deep individual and semi-structured interviews as well as taking notes. The Colaizzi analysis method was used to analyze the data. Participants and research context : 22 caregivers working with teenagers in the final stages of life in a public health centers in Iran who had the criteria to enter the study were selected using a purposeful sampling method and invited to join the study from August 2018 to June 2019. The sampling continued until data saturation. Findings : The findings of the present study were presented in the form of three main themes including "private," "respecting individual identity," and "attention to teenagers' needs" and an additional eight categories. Ethical Considerations: The study's protocol was approved by the Research Ethics Committee of the Shiraz University of Medical Sciences and all ethical principles were followed throughout the study. Discussion and conclusion : Based on the present study from the caregivers' point of view, teenagers in their final stages of life required to be cared for and taught in an environment that their privacy was maintained and their individual identity was respected as well as getting attention from the caregivers and companions. In such situations, the teenagers felt calm and their dignity was maintained; therefore, providing a cultural, professional, and organizational setting where all the components of maintaining dignity in teenagers are supported and prioritized is necessary. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nurses' clinical competence (CC) is critical in providing high-quality and safe nursing care. Assessment of nurses' CC and its predictors is a key step to improve their CC and the quality of their services. The aim of this study was to determine the predictors of CC among hospital nurses in Iran. METHODS: This analytical cross-sectional study was conducted from September 2020 to May 2021. Participants were purposively selected from four university hospitals in Hamadan, west of Iran. A demographic questionnaire and the 73-item Nurse Competence Scale were used for data collection. A total of 300 questionnaires were distributed and 270 questionnaires (response rate: 90%) were completed and returned to the researcher. Data were analyzed using the SPSS software (v. 16.0) and the one-way analysis of variance, the independent-sample t, the Mann-Whitney U, and the Kruskal-Wallis tests, the Pearson and the Spearman correlation analyses, and the linear regression analysis. RESULTS: The mean score of CC was 40.28±8.6 (in the possible range of 0-100) and the highest and the lowest dimensional mean scores were for the situation management (56.13±11) and the ensuring quality (25.3±8.1) dimensions, respectively. The mean score of CC had significant relationship with age, work experience, and ward of working and these variables significantly predicted 77% of the variance of CC (adjusted R = 0.778, P<0.05). CONCLUSION: According to the results of this study, age, work experience and ward of working weresignificant predictors of CC in hospital nurses. Nursing managers should employ strategies such as reducing nurses' workload, improving their employment status, and providing them with quality in-service education in order to improve their CC and the quality of their services. [ABSTRACT FROM AUTHOR]

Background: The families of healthcare professionals are one of the most vulnerable groups whose lives have been severely damaged by the COVID-19 pandemic. So far, the experiences and perceptions of these individuals have not been explored. The present study aims to investigate the experiences and perceptions of the family members of the healthcare professionals during COVID-19.Methods: The present study is a qualitative research with a phenomenological design. The participants were 25 family members of healthcare professionals which were selected from the medical centres in Iran via purposeful sampling from August 2021 to October 2021. The sampling was kept on until the data became saturated. To collect data, individual semi-structured interviews were conducted online. The Colaizzi approach was used to analyse the data collected.Results: The findings of the study emerged as two main themes: psychological tension with five categories (indescribable fear and worry, longing to see their loved ones, patient stone, bitter farewell, fear of the future) and dignity with four categories (acclamation, appreciation, feeling proud, spiritual growth).Conclusion: During the COVID-19 pandemic, the family members of healthcare professionals have experienced dignity combined with the degrees of psychological tension which were beyond the experiences of the majority of people in the society, but similar to the psychological tension experienced by the families of COVID-19 victims. The families of healthcare workers are continuously anxious about the safety of their loved ones who are responsible to obtain the treatment of COVID-19 patients, which potentially jeopardizes their physical and psychological well-being. Therefore, the appreciation and support of people in the community of the family members of healthcare professionals have increased their tolerance. Healthcare providers can successfully promote the health of healthcare professionals' families by providing comprehensive assistance to healthcare personnel and their families. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is a multidimensional crisis for women and their spouses that affects every aspect of their life. Coping with this disease requires investigating and resolving the challenges faced by all those affected by it. The present study was conducted to clarify these challenges on the basis of lived experiences of the spouses of women with breast cancer. Method: The present qualitative research performed an interpretive phenomenological analysis in Iran. Purposive sampling was employed to select twenty spouses of women with breast cancer. The data collected through unstructured face-to-face interviews were analyzed using van Manen's method. To ensure the rigor of the study, Lincoln and Guba's criteria were evaluated in the qualitative process. Results: Lived experiences of the spouses of the women with breast cancer in coping with challenges included the four themes of emotional confusion, shouldering the burden of care, psychophysical suffering caused by the disease and life without cohesion. Conclusion: Spouses of the women with breast cancer in the Iranian community faced several challenges and issues. The socioeconomic support provided by supporting organizations and medical personnel appear to help moderate these challenges and improve coping in this group. [ABSTRACT FROM AUTHOR]

Background. Caring for patients with coronary artery bypass grafting causes a care burden in caregivers. Objectives. The present study was conducted to investigate the effect of training on the care burden of family caregivers of patients undergoing coronary artery bypass grafting. Material and methods. This quasi-experimental design was conducted at the Heart Training-Medical Centre of the Kermanshah University of Medical Sciences, west of Iran. The participants included 100 people (two groups of 50) of family caregivers of patients undergoing coronary artery bypass grafting, selected using the convenience sampling method. Data was collected using the Novak and Guest care burden questionnaire. Caregiver training was held in three face-to-face sessions and over two telephone calls. Caregivers completed the questionnaire prior to and one month after the discharge of the patients. Results. There was no statistically significant difference in care burden and its dimensions (except for emotional care burden) between the control and intervention groups before the intervention (p > 0.05). However, after the intervention, the mean scores of care burden and its dimensions (time-dependence care burden, developmental care burden, physical care burden, social care burden and emotional care burden) significantly decreased in the intervention group compared to the control group (p < 0.05). Conclusions. Training caregivers reduces the care burden of family caregivers of patients undergoing coronary artery bypass grafting. [ABSTRACT FROM AUTHOR]

BACKGROUND: Making appropriate decisions for cardiopulmonary resuscitation (CPR) is very challenging for healthcare providers. This study aimed to evaluate knowledge, attitude, and decision making about do-not-resuscitate (DNR) and termination of resuscitation (ToR) among nurses in the resuscitation team. METHODS: This descriptive cross-sectional study was conducted in April-September 2020. Participants were 128 nurses from the CPR teams of two hospitals in Kermanshah and Hamedan, Iran. A valid and reliable researcher-made instrument was used for data collection. Data were analyzed using the Chi-square, Fisher's exact, and Mann-Whitney U tests, the Spearman's correlation analysis, and the logistic and rank regression analyses. RESULTS: Only 22.7% and 37.5% of participants had adequate knowledge about ToR and DNR. The significant predictor of DNR and ToR knowledge was educational level and the significant predictors of decision making for CPR were educational level, gender, and history of receiving CPR-related education (P<0.05). When facing a cardiac arrest and indication of DNR or ToR, 12.5% of participants reported that they would not start CPR, 21.5% of them reported that they would terminate CPR, and 14.8% of them reported that they would perform slow code. The DNR decision had significant relationship with educational level, DNR knowledge, and ToR knowledge (P< 0.05), while the ToR decision had significant relationship with educational level and ToR knowledge (P<0.05). CONCLUSION: Nurses' limited DNR and ToR knowledge and physicians' conflicting orders and documentation can cause ethical challenges for nurses. Clear guidelines for DNR orders or TOR is necessary for nurses, in order to prevent any potential confusion, legal or psychosocial issues and concerns surrounding CPR and improve their involvement in CPR decision making process. [ABSTRACT FROM AUTHOR]

Background: Standard precautions are a basic strategy to prevent occupational exposure in prehospital emergency staff. The Health Belief Model (HBM)-based education can be used to promote and educate health behavior. The aim of this study was to investigate the effect of the HBM-based education on infection control standard precautions in prehospital emergency technicians. Materials and Methods: This clinical trial study was conducted on 84 prehospital emergency staff of Hamadan who were randomly assigned to two groups: Experimental (n: 42) and control (n: 42) using a cluster method. The data were collected by a researcher-developed questionnaire. Before education, the questionnaires were completed by both groups, and then three educational sessions were held for the experimental group within one month. Two months after the intervention, the two groups completed the questionnaire and the data were analyzed by SPSS 21 software. Results: Before education, there was no significant difference in the mean scores on HBM constructs and performance between the two groups (p > 0.05). The results of the Analysis of Covariance (ANCOVA) after educational intervention showed there was a significant difference in the mean scores of all constructs and performance between the two groups (p < 0.05). Conclusions: HBM-based educational intervention could affect the scores of the model's constructs and improve the use of standard precautions in emergency medical technicians. In-service training is recommended to be developed for the staff based on HBM. [ABSTRACT FROM AUTHOR]

Home injuries are among the causes of death and disability in toddlers. Preventing home injuries is an essential part of the child health care program. Using education-based models interventions can promote mothers' practices regarding home injuries. This study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on the mothers' preventive practices regarding toddler home injuries. A quasi-experimental study was conducted on 116 mothers referred to comprehensive health centers (58 mothers in each experimental and control group), who were selected using the cluster sampling method. Data were collected using a researcher-developed TPB questionnaire, which was validated by I-CVI (≥0.78), and CVR (≥0.79). Its reliability also confirmed by Cronbach's alpha coefficients (.52-.93). Afterward, educational intervention was implemented in the experimental group based on TPB in four 45 to 60 minute sessions. After 2 months, the data were recollected from the two groups and analyzed using SPSS software version 16. Comparing the scores of TPB constructs (i.e., perceived behavioral control, behavioral intention, and subjective norms), and mothers' preventive practices regarding toddler home injuries revealed no statistically significant difference between the 2 groups pre-intervention. However, after the intervention, significant differences were observed between the 2 groups in terms of awareness, the TPB constructs (except for subjective norms), and preventive practices of the mothers (p <.001). Mothers' preventive practices regarding toddler home injuries were improved after applying TPB; hence, it is suggested a larger study be completed to confirm the results of this theory-based education. [ABSTRACT FROM AUTHOR]

Aim: Evaluation the moral courage, moral sensitivity and safe nursing care in nurses caring of infected patients by the COVID‐19. Design: This study employed cross‐sectional research. Methods: 520 nurses caring for COVID‐19 patients in 5 hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. Results: Findings showed that moral courage has a strong and direct correlation with moral sensitivity (p <.001, r = 0–.70) and safe nursing care (p <.001, r = 0–.74). Variables of moral sensitivity, safe nursing care, work experience, age and employment status can predict 64.76% of the variance in moral courage in these nurses. Nursing care of patients with COVID‐19 have reported high moral courage in recent months, and in spite of the numerous tensions and stresses in terms of caring these patients during this relative long period, they are still diligent in providing safe and high sensitive care to these patients. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Spiritual health is one of the important dimensions of the elderly's health, which plays an important role in other dimensions of their health. This study aimed to explain the process of spiritual health of the elderly living in nursing homes. METHODS: This grounded theory study was conducted in 4 nursing homes in the city of Arak Iran between October 2019 and September 2020. The participants were 24 elderly people living in nursing homes, two health care providers, one nurse and one family member, first selected through purposive sampling and then, through theoretical sampling. The data were collected through semi-structured interviews and field notes. All the interviews were transcribed verbatim and analyzed based on Strauss and Corbin approach (2008). RESULTS: Six main categories were identified, including helplessness, inefficient supportive environment, spiritual distress, seeking support, relative improvement of spiritual health and factors affecting spiritual health, each of which explains a part of the whole process of spiritual health of the elderly living in nursing homes. CONCLUSION: Supporting the elderly living in nursing homes is necessary in order to meet their spiritual needs and preserve and promote their spiritual health. [ABSTRACT FROM AUTHOR]

Background: Care and treatment adherence are important factors for given good liver transplantation outcomes. Objectives: Design and validate an instrument to appraise adherence to care and treatment in liver transplantation recipients. Methods: Amixed-methods sequential exploratory study was conducted in two phases from2017 to 2019, in the Liver Transplantation Clinic Tehran, Iran. In the qualitative phase, the concept of care and treatment adherence in liver transplantation recipients extracted by a conventional content analysis was performed on semi-structural interviews that were conducted on 18 liver transplantation recipients that were recruited through purposive sampling technique. Also, two physicians, one nurse coordinator of the liver transplantation team, and two family members were interviewed. The scale was developed based on operational definitions extracted from the qualitative phase. The validity was assessed by face, content, construct validity, and confirmatory factor analysis. The reliability was also evaluated by calculating test-retest intraclass correlation coefficient and Cronbach's alpha. The exploratory factor analysis was carried out with 286 filled the questionnaire. Results: Four factorswere extracted in factor analysis. These factors explained 45.622% of the variance. The final version of the scale consisted of 20 items. The Cronbach's alpha coefficient reported as 0.889 for the total scale and the intraclass correlation coefficient was reported as 0.912. The confirmatory factor analysis led to a fittingmodel. Chi-square indices were reported as CMIN/DF = 2.34, NFI = 0.94, CFI = 0.96, and RAMSEA = 0.067. Conclusions: With a four factors structure, validity and reliability of adherence to care and treatment scale are acceptable; therefore, it can be used for appraisal care and treatment adherence in liver transplant recipients. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a problem that affects not only the individual's health and quality of life, but also the functionality of the family system. Caregivers experience stress when their patients cannot cope with the symptoms of their disease. The stress experienced by caregivers gives rise to psychological and physical symptoms in them. This study seeks to present a complete set of tools for assessing coping in the spouses or caregivers of women with breast cancer and evaluate the various instruments developed within these lines of inquiry. Methods: A search was carried out in PubMed, Scopus, Web of Science, CINAHL, PsycINFO, Medline, ProQuest, Scopus and Google Scholar and also in the reference lists of the key articles retrieved for any coping assessment instrument targeting family caregivers' needs that had acceptable psychometric properties and was published until September 2019. The instruments used to assess coping in the spouses and caregivers of women with breast cancer were thus identified and their properties were described. Results: Overall, 88 adaptation assessment tools related to family caregivers of patients with breast cancer were identified in 28 related articles. The tools examine different dimensions of adaptation such as satisfaction, stress, burden and needs of spouses and caregivers of patients with breast cancer. Conclusion: Assessing family caregivers' coping is essential for providing them with the appropriate sources of support. Although several instruments have been used to assess coping in the spouses and caregivers of women with breast cancer, the properties of these instruments have to be examined before they can be more widely implemented. [ABSTRACT FROM AUTHOR]

Background: Sleep quality is one of the main human factors related to urban road traffic crashes. This study aimed at determining the relationship between sleep quality and road traffic crashes in urban drivers. Methods: This correlational study was conducted in Hamadan, a city located in the western part of Iran. The study samples consisted of 309 Hamadan drivers (i.e., 103 with road traffic crashes (RTCs) and 206 without RTCs), who were referred to police centers to change or renew their driving licenses. The data collection tool was a two-part questionnaire including demographic information and the Pittsburgh Sleep Quality Index (PSQI). The questionnaire was filled out in a self-administered manner. Statistical analysis was done using the SPSS-16 software and applying logistic regression, Fisher's exact test, and Chi-square test. Results: The comparison of sleep quality scores between two groups, using the adjusted logistic regression test, showed a statistically significant difference between them (P = 0.019). This means that the sleep quality of drivers without RTCs was 1.8 times better than drivers with RTCS (OR=1.8; 95% CI, 1.1 - 3.07). Conclusions: There was a significant association between poor sleep quality and the occurrence of RTCs in urban drivers. As a result, it is recommended paying more attention to the sleep quality of urban drivers to prevent and control RTCs. [ABSTRACT FROM AUTHOR]

Background: Identifying the status of clinical education helps to improve the achievement of educational goals. This study aimed to compare the achievement of clinical skills in the final year nursing students. Materials and Methods: In this descriptive analytical study, 157 nursing students in the seventh and eighth semesters were selected through a census method, who were compared with each other. Data were collected using a researcher-developed questionnaire that included 111 clinical skills in 7 dimensions of primary nursing care, vital signs control, oxygenation and airway management, medication administration, laboratory samples collection, infection control, and cardiopulmonary resuscitation skills. Students scored each skill on a scale ranging from 0 to 5. The acceptable skills level in this study was the third level, which observes skills performed by the instructor or the nurse. Data were analyzed using the Kolmogorov–Smirnov test, descriptive statistics, and multiple linear regression. Results: In the seventh semester students, except for the vital signs skills, other skills were at lower than expected levels. In the eighth semester students, except for the laboratory samples collection and infection control skills which were at a lower than expected level, other skills were reported at expected levels. Multiple linear regression showed that the eight semester students had more total score than the seventh semester students (t = 3.19, p = 0.002). Conclusions: The provision of sufficient opportunity to develop clinical skills in the eight semester was observed in this study; therefore, it is recommended that the internship course be increased in the dimensions in which students can independently perform clinical skills. [ABSTRACT FROM AUTHOR]

The article examines the factors that lead to patients experiencing reductions in physical, cognitive, and psychosocial functions after liver transplantation and how they impact their adherence to care and treatment. It notes that the growing number of patients with liver transplantation, difficulties and challenges like insufficient donors and high health care costs has increased the demand for a clear description of health self-management in patients with liver transplantation.

Background: Multiple sclerosis is a common debilitating chronic disease of the central nervous system with a progressive and prolonged nature. Patients need an adjusted lifestyle and continuous care in order to prevent its recurrence and progressive disabilities. This study aimed to assess the effect of continuous care on lifestyle in patients suffering from multiple sclerosis. Materials and Methods: A randomized clinical trial was conducted among 72 patients with multiple sclerosis who referred to the Farshchian Educational Hospital in Hamadan, Iran in 2013. The patients were allocated to intervention and control groups using balanced block randomization with blocks of four. The steps of continuous care (orientation, sensitization, control, and evaluation) were implemented in the case group for 2 months. The patients' lifestyle was assessed before and 1 and 2 months after continuous care using the researcher-developed Lifestyle Questionnaire. The data were analyzed using the Chi-square test, t-test, and repeated-measures analysis of variance. Results: The mean score of lifestyle and its dimensions were significantly higher in the intervention group 1 and 2 months after the intervention compared to the baseline (P = 0.001). In contrast, the mean score of lifestyle and its dimensions had no significant difference in the control group 1 and 2 months after routine care compared to the baseline. Conclusions: Continuous care improved the patients' lifestyle. It could be designed as an appropriate care system into the hospitals or other health care centers. This care system could be used widely in order to improve adherence to suitable lifestyle in patients with chronic diseases. [ABSTRACT FROM AUTHOR]

Background: Pediculosis capitis is a problem in children and has worldwide distribution. The aim of the present study was to determine the prevalence of pediculosis degree and its relevant factors in the secondary schools in Hamadan west of Iran. Methods: The study was carried out in two phases. A cross-sectional procedure was used to determine the prevalence of pediculosis, and the case study was done to identify the relevant factors to the infestation. Totally, 10841 secondary students were chosen and classified in accordance with the clustering sample. Results: The prevalence of pediculosis was 1.05%. It was 1.27% among the urban student; whereas 0.05% among the rural students. About 2.3% belonged to female students, and 0.11% was pertained to the male students. The greatest amount of infestation prevalence was reported from the schools of urban areas particularly in the public schools of suburbia. Furthermore, the prevalence of infestation was more where some individuals had pediculosis previous history and suffered from head inching. It turned out to be a significant relationship between pediculosis, head itching (P<0.001) and previous history of pediculosis (P<0.001). Conclusions: The prevalence of pediculosis in Hamadan is low, but is more in the areas which are deprived of the access to health facilities. Therefore, there is a need for educational campaigns about danger of infection and regular mass screening at school. [ABSTRACT FROM AUTHOR]

Background: Although nursing education in Iran has a positive trend in growth; it is still facing with multifaceted challenges. This study aims to explore the challenges for effective evaluation of nursing education perceived by academic managers. Materials and Methods: A qualitative study was performed by using 21 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran. All interviews were recorded digitally, transcribed verbatim, and analyzed by qualitative content analysis. Results: The main challenges could be categorized under 3 themes, each included 3 subthemes: managerial issues (inefficacy of management, inadequacy of policies and strategies, ineffective evaluation planning); administrative issues (inefficient and affected evaluators, inappropriate implementation, and inefficacy of approaches and tools); and structural issues (inappropriate culture, clinical education complexity, lack of alumni follow-up system). Conclusions: The results emphasize the need for educational evaluation development in nursing, including systematic and regular educational evaluation planning focusing on efficient feedback system and regard to excellence models. The comprehensive educational evaluation requires participation, involvement, and collaboration among the Nursing Board, Nursing ministerial office, faculties of nursing, and Nursing Organization. Thus, it is necessary to better designate current educational evaluation systems, policies, approaches, methods, and procedures. [ABSTRACT FROM AUTHOR]

Background and aims: One of the most challenges in diabetic patients is learning how to glycemic control. Evidence based care is proper, correct and intellectual use of the best evidence in clinical decision making for every single patient care. This study aimed to determine the effect of evidence based care on glycemic control in type 2 diabetes patients. Methods: This study was a clinical randomized controlled trial which conducted on sixty diabetic type 2 patients. Patients were divided in two groups of intervention and control. Nursing interventions based (exercise & nutrition) on a review of the literature. Data were collected using questionnaire and checklist before and three months after the intervention. Data were analyzed using SPSS/20. Results: The results showed that after evidence based care, fasting plasma glucose test in the intervention group than in control group, the difference was statistically significant (P<0.05) Conclusion: With designing evidence-based nursing care instructions for type-2 diabetic patients, the need of clinical nurses in confronting these patients was removed. It also leads to improve the quality of care and reduce complications in duration of the hospital stay. [ABSTRACT FROM AUTHOR]

Background and aims: learning plays an important role in developing nursing skills and right care-taking. The Present study aims to evaluate two learning methods based on team - based learning and lecture-based learning in learning care-taking of patients with diabetes in nursing students. Method: In this quasi-experimental study, 64 students in term 4 in nursing college of Bukan and Miandoab were included in the study based on knowledge and performance questionnaire including 15 questions based on knowledge and 5 questions based on performance on care-taking in patients with diabetes were used as data collection tool whose reliability was confirmed by cronbach alpha (r=0.83) by the researcher. To compare the mean score of knowledge and performance in each group in pre-test step and post-test step, pair-t test and to compare mean of scores in two groups of control and intervention, the independent t-test was used. Results: There was not significant statistical difference between two groups in pre terms of knowledge and performance score (p=0.784). There was significant difference between the mean of knowledge scores and diabetes performance in the post-test in the team-based learning group and lecture-based learning group (p=0.001). There was significant difference between the mean score of knowledge of diabetes care in pre-test and post-test in base learning groups (p=0.001). Conclusion: In both methods team-based and lecture-based learning approaches resulted in improvement in learning in students, but the rate of learning in the team-based learning approach is greater compared to that of lecture-based learning and it is recommended that this method be used as a higher education method in the education of students. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer is a multidimensional crisis for women and their spouses that affects every aspect of their life. Coping with this disease requires investigating and resolving the challenges faced by all those affected by it. The present study was conducted to clarify these challenges on the basis of lived experiences of the spouses of women with breast cancer. Method : The present qualitative research performed an interpretive phenomenological analysis in Iran.Purposive sampling was employed to select twenty spouses of women with breast cancer. The data collected through unstructured face-to-face interviews were analyzed using van Manen's method. To ensure the rigor of the study, Lincoln and Guba's criteria were evaluated in the qualitative process. Results: Lived experiences of the spouses of the women with breast cancer in coping with challenges included the four themes of emotional confusion, shouldering the burden of care, psychophysical suffering caused by the disease and life without cohesion. Conclusion: Spouses of the women with breast cancer in the Iranian community faced several challenges and issues. The socioeconomic support provided by supporting organizations and medical personnel appear to help moderate these challenges and improve coping in this group., (Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Making appropriate decisions for cardiopulmonary resuscitation (CPR) is very challenging for healthcare providers. This study aimed to evaluate knowledge, attitude, and decision making about do-not-resuscitate (DNR) and termination of resuscitation (ToR) among nurses in the resuscitation team., Methods: This descriptive cross-sectional study was conducted in April-September 2020. Participants were 128 nurses from the CPR teams of two hospitals in Kermanshah and Hamedan, Iran. A valid and reliable researcher-made instrument was used for data collection. Data were analyzed using the Chi-square, Fisher's exact, and Mann-Whitney U tests, the Spearman's correlation analysis, and the logistic and rank regression analyses., Results: Only 22.7% and 37.5% of participants had adequate knowledge about ToR and DNR. The significant predictor of DNR and ToR knowledge was educational level and the significant predictors of decision making for CPR were educational level, gender, and history of receiving CPR-related education (P<0.05). When facing a cardiac arrest and indication of DNR or ToR, 12.5% of participants reported that they would not start CPR, 21.5% of them reported that they would terminate CPR, and 14.8% of them reported that they would perform slow code. The DNR decision had significant relationship with educational level, DNR knowledge, and ToR knowledge (P< 0.05), while the ToR decision had significant relationship with educational level and ToR knowledge (P<0.05)., Conclusion: Nurses' limited DNR and ToR knowledge and physicians' conflicting orders and documentation can cause ethical challenges for nurses. Clear guidelines for DNR orders or TOR is necessary for nurses, in order to prevent any potential confusion, legal or psychosocial issues and concerns surrounding CPR and improve their involvement in CPR decision making process., (© 2022 Goodarzi A., et al.)

Purpose: This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences., Methods: This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically., Results: The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity., Conclusion: The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.

Introduction: Assessing cardiopulmonary resuscitation (CPR) outcomes of patients with COVID-19 and employing effective strategies for their improvement are essential. This study is designed in this regard., Methods: This cross-sectional study was conducted between January 20, 2020 and January 20, 2021 in the emergency departments of two hospitals in Hamadan and Kermanshah, Iran. Participants were 487 patients with confirmed COVID-19 and cardiac arrest (CA) who had undergone CPR during the study period. Data were collected using the available CPR documentation forms developed based on the Utstein Style and analyses were performed using Chi-square, Fisher's exact, and Mann-Whitney U tests and the logistic regression analysis., Results: Participants' mean age was 69.31±14.73 years and most of them were male (61.8%) and suffered from at least one underlying disease (58.1%). The rate of total and in-hospital CA was 9.67% and 9.39%, respectively. The most prevalent first documented rhythm was asystole (67.9%) and the highest responsivity to CPR was for shockable rhythms. The rate of the return of spontaneous circulation (ROSC) was 9% and the rate of survival to hospital discharge was 2%. The significant predictors of CPR success were age (p = 0.035), epinephrine administration time interval (p = 0.00), CPR duration (p = 0.00), and First documented rhythm (p = 0.009)., Conclusion: The rate of in-hospital CA among studied COVID-19 cases was 9.39% with 9% ROSC and 2% survival to hospital discharge rates after CPR. Primary CPR success among patients with COVID-19 was poor, particularly among those with asystole and bradycardia. It seems that old age and improper doses of epinephrine can reduce CPR success.

Introduction: Le cancer du sein provoque une crise multidimensionnelle qui ébranle non seulement la patiente, mais aussi le conjoint et les autres membres de sa famille. Il convient donc d'étudier l'adaptation à ce phénomène, qui constitue l'une des principales difficultés pour les proches. En comprenant mieux comment les conjoints de femmes atteintes d'un cancer du sein font face à cette crise, ces derniers pourraient mieux prendre soin de leurs épouses et améliorer leur qualité de vie., But De L’étude: L'étude visait à explorer le concept d'adaptation à partir d'expériences vécues par les conjoints de femmes souffrant d'un cancer du sein., Méthodologie: Cette étude qualitative a été réalisée en 2019 selon une approche phénoménologique dans les villes de Hamadan et Rasht, en Iran. Le groupe de participants comptait 20 conjoints de femmes atteintes du cancer du sein, recrutés grâce à une méthode d'échantillonnage par choix raisonné. Les données ont été recueillies au moyen d'entretiens non structurés en personne; elles ont été analysées à l'aide de la méthode phénoménologique en six étapes de van Manen., Résultats: Les expériences vécues par les participants ont montré que le phénomène d'adaptation des conjoints au cancer du sein de leur femme se décline en cinq thèmes: souffrance émotionnelle, fardeau des soins, maintien de la cohésion familial, incertitude de l'avenir et sentiment de perte du concept de soi. La compréhension du concept d'adaptation chez les conjoints de femmes atteintes du cancer du sein dans les stratégies de santé peut aider les femmes à bien s'adapter, tout en aidant les professionnels à adopter des mesures efficaces dans le domaine des soins médicaux, pour les patientes et leurs conjoints., Competing Interests: Déclaration de conflit d’intérêts: Aucun conflit d’intérêts potentiel n’a été déclaré par les auteurs., (© 2021 Canadian Association of Nurses in Oncology (CANO).)

Background: Breast cancer is a problem that affects not only the individual's health and quality of life, but also the functionality of the family system. Caregivers experience stress when their patients cannot cope with the symptoms of their disease. The stress experienced by caregivers gives rise to psychological and physical symptoms in them. This study seeks to present a complete set of tools for assessing coping in the spouses or caregivers of women with breast cancer and evaluate the various instruments developed within these lines of inquiry., Methods: A search was carried out in PubMed, Scopus, Web of Science, CINAHL, PsycINFO, Medline, ProQuest, Scopus and Google Scholar and also in the reference lists of the key articles retrieved for any coping assessment instrument targeting family caregivers' needs that had acceptable psychometric properties and was published until September 2019. The instruments used to assess coping in the spouses and caregivers of women with breast cancer were thus identified and their properties were described., Results: Overall, 88 adaptation assessment tools related to family caregivers of patients with breast cancer were identified in 28 related articles. The tools examine different dimensions of adaptation such as satisfaction, stress, burden and needs of spouses and caregivers of patients with breast cancer., Conclusion: Assessing family caregivers' coping is essential for providing them with the appropriate sources of support. Although several instruments have been used to assess coping in the spouses and caregivers of women with breast cancer, the properties of these instruments have to be examined before they can be more widely implemented., Competing Interests: The authors declare that they have no competing interests., (© 2020 Jahani Sayad Noveiri et al.)